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目的对382例绝经后阴道出血患者进行分析,以探索其病因及相关因素。方法对天津市黄河医院2008-11-2009-11妇科门诊就诊的9 578例中,符合绝经后阴道出血诊断标准的382例进行阴道分泌物涂片检查、活组织检查、手术后标本病理检查。结果绝经后阴道出血原因最多见的是阴道炎(30.63%),其次为慢性宫颈炎(21.73%)、功能性子宫出血(12.58%)I、UD(12.04%)、恶性肿瘤(6.54%)。结论绝经主要原因是随着卵巢功能衰退至停止,子宫内膜仍受雌激素刺激使内膜增生过长、出血、甚至有内膜癌变的潜在危险因素。IUD可引发宫腔感染、出血,而阴道出血与恶性肿瘤有明显的相关性,因此应把绝经后阴道出血视为一危险信号加以重视。
Objective To analyze 382 cases of postmenopausal vaginal bleeding in order to explore its etiology and related factors. Methods A total of 3878 cases of 9788 gynecological outpatients attending the Yellow River Hospital in Tianjin from 2008 to 2009 were retrospectively analyzed. Pap smears, biopsies and postoperative pathological examinations were performed in 382 patients who met the diagnostic criteria of postmenopausal vaginal bleeding. Results The most common causes of vaginal bleeding after menopause were vaginitis (30.63%), followed by chronic cervicitis (21.73%), functional uterine bleeding (12.58%), UD (12.04%) and malignant tumor (6.54%). Conclusions The main cause of menopause is that as ovarian function decline to stop, the endometrium is still stimulated by estrogen to prolong intima hyperplasia, hemorrhage and even potential risk factors of endometrial cancer. IUD can cause uterine infection, bleeding, and vaginal bleeding and malignant tumors have a clear correlation, so the postmenopausal vaginal bleeding should be regarded as a danger signal to be valued.